Berlin Heart EXCOR Pediatric VAD, Manual, Page: 164 / 250

Chapter 13 Weaning and Explantation for BTR and BTT
13.1.4 Weaning Protocol
WARNING
Rates < 60 bpm are intended to be used only for implantation and
explantation. Never use the
Ikus with a rate < 60 bpm without constant
supervision.
If the patient does not meet the eligibility criteria at any time during the
weaning process: Resume pumping at rate prior to any weaning (initial
rate, IR).
The weaning protocol can be divided into 5 steps and generally takes one week to
complete.
• Day 0 (and throughout the weaning process). Confirmation of eligibility criteria for
weaning.
• Day 0. Acute weaning challenge
• Day 1-4. Graduated weaning challenge with non-invasive assessment (echo).
• Day 5. Pump stoppage with invasive hemodynamic assessment with afterload
challenge.
• Day 6. Pump stoppage with invasive hemodynamic assessment in OR (full
anticoagulation).
This size-based weaning protocol accounts for physiologic differences in heart rate
and stroke volume observed in children of varying ages.
13.1.5 10 ml / 15 ml pump
The individual weaning progress is based upon the following parameters:
Parameter Explanation Abbr. Value
initial rate rate prior to any
weaning IR Please enter:
IR = ______ bpm
weaning
rate lowest rate
achieved during
weaning
process,
depends on
pump size WR 50 bpm
total
weaning
interval Difference
between initial
rate and
explantation rate:
TWI = IR - WR TWI Please enter:
IR ___ bpm - WR 50 bpm =
TWI ___ bpm
reduced
rate rate resumed at
the end of day 1
to 3 RR
1
to
RR
3
Please refer to Tab. 13-2,
page 155.
Tab. 13-1 Important parameters for weaning progress
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